Infective endocarditis: modern views on pathogenesis

Infective endocarditis: modern views on pathogenesis

M.O. Anishchenko, N.S. Сhipigina, N.U. Carpova, A.A. Klimenko 

Pirogov Russian National Research Medical University, Moscow

Infectious endocarditis (IE) is characterized by high mortality (up to 30%), and 27–42.8% of fatal IE cases are not recognized in life. Despite the high level of development of medicine as a branch of science, IE remains a condition with poorly understood pathogenesis. IE is a good example of the interaction between blood coagulation and innate immunity, which is referred to as immunothrombosis by some authors. Recently, increased attention has been paid to the role of hemostasis, innate immunity, and pathogenic factors of microorganisms in the development and progression of IE. The high rate of systemic complications (i.e., thromboembolism, multiple organ dysfunction syndrome, and complex immune lesions) in IE makes searching for the causes and predictors of complications one of the highlights of IE studies. This paper reviews data on the role of interactions between blood coagulation and the immune system in IE. Special attention is paid to neutrophil extracellular traps as a new pathogenic link in IE, virulence factors of Staphylococcus aureus and streptococci as the most common pathogens of IE, and laboratory predictors of thromboembolism.

Keywords: infectious endocarditis, pathogenesis of infectious endocarditis, immunothrombosis, von Willebrand factor, neutrophil extracellular traps, complications of infectious endocarditis, predictors of thromboembolism, Staphylococcus aureus, Streptococcus.

For citation: Anishchenko M.O., Сhipigina N.S., Carpova N.U., Klimenko A.A. Infective endocarditis: modern views on pathogenesis. RMJ. 2023;10:43–47.